Organization
JOHNSON & ROLLOLAZO, A PROFESSIONAL CORPORATION
Active
Other names
Talega Coast Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DEAN ROLLOLAZO R.D.H. (CEO/BUSINESS MANAGER)
(206) 351-6252
Entity
Organization
Contact information
Practice address
1031 AVENIDA PICO STE 203, SAN CLEMENTE, CA 92673-6356
(949) 361-6900
Mailing address
1031 AVENIDA PICO STE 203, SAN CLEMENTE, CA 92673-6356
(949) 361-6900
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
54070
CA
Other
Enumeration date
11/12/2014
Last updated
11/12/2014
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